Healthcare Provider Details

I. General information

NPI: 1902441546
Provider Name (Legal Business Name): OASIS CHILD AND FAMILY SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/07/2019
Last Update Date: 05/13/2026
Certification Date: 05/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7900 EXCELSIOR BLVD
HOPKINS MN
55343-3445
US

IV. Provider business mailing address

7900 EXCELSIOR BLVD STE 80
HOPKINS MN
55343-3446
US

V. Phone/Fax

Practice location:
  • Phone: 763-312-1878
  • Fax:
Mailing address:
  • Phone: 763-312-1878
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103TC2200X
TaxonomyClinical Child & Adolescent Psychologist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code261QM0855X
TaxonomyAdolescent and Children Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: ANGEL PAIGE
Title or Position: PROVIDER
Credential: LPCC
Phone: 763-312-1878